Form used by students to apply for work study employment. If you are interested in the work study program, please complete this application and email it to the Office of Financial Aid: finaid@upstate.edu.

All sections need to be completed by your health care provider.
Laboratory testing for antibody titers is required and copies of the laboratory report must be returned with the form. Dates of immunization alone are not acceptable.

To be completed by the student with each item being checked and an explanation for all "yes" answers in the space provided. You may use an additional sheet, if necessary. Your health care provider needs to complete the summary section, sign and date.

In this manual, you will find 20 brief sequential lessons (each lesson builds on the previous
lesson; lessons are encouraged to be read at a rate of at least one per week) outlining various
strategies to facilitate weight loss.